[Acceptance of sterilization by tubal ligation by women (author's transl)].
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Attitude to Health↗
Biomedical subjects
J M Wenderlein
Publications and source records attributed to J M Wenderlein.
[Clinical trends in 520 twin pregnancies in 22 years].
In the last 22 years 520 twin pregnancies were seen at the Department of Obstetrics and Gynecology, University of Ulm. The material was analyzed retrospectively according to the 4 time periods 1965-1974, 1975-1980, 1981-1983, and 1984-1987. An equal-size group of singleton pregnancies was used as control. 1. By the 20th week the diagnosis had been established in 67% between 1984 and 1987 and 29% between 1975 and 1980. 2. A cervical cerclage was most commonly done between 1981 and 1983 (75%). The frequency decreased afterwards and a cerclage was only done in 18% in 1987. 3. Tocolytic agents were used in 7% between 1965 and 1974 and in two thirds of cases in the last years. 4. Hospital admission before delivery was most common between 1975 and 1980 (33%). In the last 7 years it was only half as common (15%). 5. There was no difference in the frequency of preeclampsia and eclampsia between singleton and twin pregnancies in the last years. 6. Maternal hemoglobin levels below 10% were more common in twin pregnancies than in the control group: Before delivery 11%, after delivery 22% in the twin pregnancies, compared with 6% and 4% in the singleton pregnancies. 7. There was no increase in the duration of pregnancy in the last 22 years. The difference between actual birth date and estimated date of delivery remained about the same in the 4 examined time periods: 21 days, 20 days, 21 days, 27 days. There was a slight increase in the frequency of delivery before the 37th week in twin pregnancies: 38%, 41%, 43%, 47%.
Female↗
[Perinatal aspects of 520 twin deliveries between 1965-87 at the Ulm University Gynecologic Clinic].
1. Birth induction in twin pregnancies was substantially reduced to 6% in last few years (1984-87) as opposed to 21% between 1975 and 1980. 2. Premature rupture of the membrane increased in the last years. At a rate of 33% is occurred nearly twice as often as with singletons (18%). A waiting policy increasingly adopted in such cases resulted in 21% of the twin group and 9% of the singleton group being born as late as 48 hours and beyond after membrane rupture. 3. The frequency of Caesarean sections performed in twin pregnancies rose dramatically over the last 22 years: 16%, 36%, 43%, 45%. With singletons, the tendency is reverse: 6%, 22%, 15%, 9%. One of the reasons why Caesarean sections are so markedly on the increase is that the frequency of immaturity in twins is steadily rising. In the past two decades the percentage of second twins less than 2500 grams birth weight rose from 35% to 71%. 4. Labour duration exceeding 12 hours increased from 8% to 21%. The same applies to the expulsion time of the first twin which rose on average from 10 to 21 minutes. 5. Manual delivery of the placenta remained at a steady rate of 25%, compared to 10% after singleton deliveries. 6. Hospitalization time exceeding two weeks decreased in the study period from 33% to 5%. 7. The perinatal mortality rate of twins could be halved in the period from 1965 to 1987, to less than 4%. The frequency of Caesarean sections, on the other hand, increased threefold to 48% now.(ABSTRACT TRUNCATED AT 250 WORDS)
Cesarean Section↗
[Disorders of bladder emptying after labor. Study of 511 puerperal patients regarding the incidence and risk of residual urine post partum].
In a Study of 500 unselected women in childbed interested the incidence and risk factors of residual urine over 50 ml (RH), sonographically proven in the first days after birth. The incidence after vaginal birth was 17% and after C-section 13%, 7% and 1% suffered from a urinary tract infection respectively. The RH-phenomenon lasted approximately 3 days. Significant risk factors have been: vaginal-operative deliveries (forceps, Vacuum-Extraction) protracted deliveries (over 12 hours) protracted expulsion period (over 1 hour) longer expulsive periods (over 15 minutes) newborn head-circumference over 36 cm I-Parae with episiotomy -PDA had only an additive effect. The shown quantitative aspects make it easier to evaluate the risk and the exact sonographic search for residual urine in the days pp.
Adult↗
[Postpartum neonatal weight increase in relation to the course of pregnancy (retrospective study of 791 newborn infants)].
In a retrospective pilot study the weight development of 791 neonates in the first five postpartal days was related to clinical and social data relevant for the course of pregnancy. I. Pregnancy Course 1. For a variety of reasons, neonates of mothers hospitalized for more than two weeks during pregnancy had regained their birthweight by the 5th postpartal day significantly less often than infants of non-hospitalized women (7% versus 27%). 2. In newborns whose mothers had suffered from hyperemesis gravidarum weight loss in the first five postpartal days was seen twice as often as in the rest of the group (67% versus 33%). 3. Postpartal weight loss of infants from gestotic mothers tended to be higher and of longer duration compared to the remainder of the group. 4. The same phenomenon was seen in diabetic pregnancies. 5. Neonates from smoking mothers had a significantly lower postpartal weight loss and had regained their birthweight by the 5th postpartal day much more often (35% versus 23). II. Social data 1. Newborns from mothers aged up to 18 years reached their birthweight by the 5th postpartal day only half as often as infants whose mothers were aged between 18 and 35 (13% versus 26%). Even if preterm babies were excluded, this trend remained. 2. Distinct postpartal weight loss occurred much more often in infants of multiparous mothers (3 and more children) compared to the rest of the study group (29% versus 18%). 3. Somewhat surprisingly, newborns of mothers from islamic countries regained their birthweight earlier than neonates of German mothers.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
[Evolution promotes a minimal effect of fetal labor stress during birth].
Controlled labor-caused fetal stress during birth can be tolerated better than generally suspected. This is the result of a pilot study among 1000 term infants in which the postpartum development of neonate weight was evaluated as a simple parameter of adaptation to extrauterine life. I. The clinical relevance of postpartum weight development was demonstrated in newborns whose mothers had been hospitalized during pregnancy e.g. because of hyperemesis, diabetes or gestosis. Postpartum these newborns showed longer lasting and more extensive weight loss. II. On the contrary moderate fetal stress during labor results in less and shorter lasting weight loss of the newborn term infants born after a labor-period of 12 hours showed a weight loss greater than 5% of their birth weight. Only half as often as newborns after a shorter period of labor. Further parameters of stress like a 1 minute APGAR score up to 6 versus 1 minute APGAR between 8 and 10 or umbilical cord ph-values below and over 7.20 revealed the same tendency. Newborns with green amniotic fluid (as a sign of stress) during birth also had a lower weight loss (up to 2% of birth weight) twice as often as newborns without green amniotic fluid. A statistically significant relation was also seen between the way of delivery as another aspect of stress and postpartum weight: on the 5th day postpartum newborns delivered by cesarean section showed a weight below birth weight three times as often as babies delivered by vaginal-operation means. The evolutionary aspect of catecholamine-peak during birth as protection against labor-induced hypoxemia and as advancing factor of adaptation to extrauterine life makes the results of this study seem plausible. This topic deserves more clinical research.
Acid-Base Equilibrium↗